Psychosocial status at initiation of cancer treatment and survival

Ninety-two newly diagnosed patients with hematologic malignancies treated with chemotherapy, and 47 patients with rectal cancer treated with abdominal-perineal resection were prospectively studied to assess the relationship between mood and survival. Hematology patients were measured within one week of diagnosis and were remeasured at six months. Rectal cancer patients were measured within three months of surgery and remeasured six months later. Medical records were abstracted to obtain data on treatment given, disease characteristics and outcome of treatment. On univariate analyses using Cox regression, we examined the effect of depression, coping style and locus of control on survival. None of these variables were found to be significantly related to survival whether assessed at intake or six months later. Furthermore there were no statistically significant correlations between these factors and subsequent survival at two years or with long-term survival. Biological prognostic variables including extent of disease for rectal cancer patients and severity of specific type of hematologic cancer were significantly related to survival. Although psychosocial adjustment is important for the quality of life experienced by cancer patients it was not related to length of survival in this study. Further exploration of this issue should be conducted using patients with a single site and preferrably an early stage of disease.